Name (optional)

Are you:

Female
Male

In what year were you born?

What county in Ireland are you from?

What is your marital status?

Single
Married
Divorced
Widowed

Where do you currently live? (Neighbourhood, City, State)

What is your occupation?

What passport(s) do you hold?

Irish
U.S.
Other

Do you have children? If yes, how many?

No
1-2
3 +

If you do have children, please list their ages.

In what year did you first move from Ireland to the U.S.?

In what year did you move back from the U.S. to Ireland?

In what year did you re-migrate from Ireland to the U.S.?

Are you potentially interested in participating in this research project? Answering "yes" at this point will by no means be taken as an indication of willingness to take part, merely that you are willing to be contacted. I anticipate that participation will probably involve one or two interviews to be scheduled at your convenience over the summer months.

Yes
No

If you answered "yes" above, and are willing to be contacted concerning possible participation, please enter your email address below:

Any further comments, questions or input: